Isaac Benjamin Paz, M.D.
Vice Chair for Clinical Affairs, Department of Surgery at City of HopeFollow this author
Performing surgery might seem removed from the personal interactions that family doctors have with patients over the years. When a surgeon removes a gallbladder, for example, there’s not significant personal interaction built around the procedure.
On the other hand, for Dr. Isaac Benjamin Paz – who treats cancer patients – the patient-surgeon interaction is a long-term and closer relationship.
For Dr. Paz, surgery is a highly technical and demanding specialty, of course. But treating cancer also involves an ongoing relationship with the patient and the patient’s family – throughout a journey that is always emotional and often intimate.
“For me, the most important thing is trust,” said Dr. Paz. “If you trust me, I will work with you and your family to help you to navigate and arrive at the right decisions, which are different for every person. We’re all part of the team, and the most important members of that team are the patient and their family.”
Dr. Paz is the vice chair for clinical affairs of the Department of Surgery at City of Hope, a world leader in the research and treatment of cancer, diabetes and other life-threatening diseases. He is renowned for his expertise in breast cancer, gastrointestinal and rectal cancers, and tumors involving the bone and soft tissues. He specializes in minimally invasive surgery and has developed one of the leading centers for minimally invasive surgery in oncology in California. Oncology deals with the study, treatment, diagnosis and prevention of cancer.
“My job is not just to treat cancer,” he explained. “My job is also to help people understand how to overcome the fear. You have to make decisions. You have to be able to overcome that fear so you can make the most rational decision on behalf of your cancer care.”
The fundamental message he gives to patients is that when you’re going through treatment for cancer, you’re doing this TO LIVE, you’re not doing this to not die. That’s an important distinction.
As he put it, we all have an idea of what our life is and what our future will look like. But a diagnosis can change that.
“Your life might change because of this diagnosis, and because of the treatment associated with the diagnosis. You have to adapt to that, you don’t have an option. But ultimately life is what you’re trying to do. That’s very different than not dying.”
When he was young, Dr. Paz was sure he was going to be an engineer. He had the highest scores in math and physics in Chile, where he is from. His father and three brothers are all engineers.
“There was no question about it, I was going to be an engineer,” he said. “All of us in my family are a little bit quirky, and I thought that was because we were engineers. I was trying not to be so quirky, so I decided I would go a slightly different route – to become a bio-medical engineer.”
That profession didn’t exist when he entered college in 1975. To pursue it, he had to study both medicine and engineering. He intended to take the first years of medicine and then transfer into engineering. In the process, he discovered surgery.
“Being a surgeon has a tremendous amount of creativity. Doing surgery is like painting or sculpting. There’s an art to it, there’s creativity to it. In the beginning, it’s challenging and it’s difficult. Then it flows, and it’s pleasant. I always think of poets – they can paint with words, they paint emotions. Words get a totally different meaning when they use them. There’s music to it. Surgery has that same aspect. That music, that art. When you do something that’s special, you enjoy that.”
Also, he liked that cancer can’t be treated by a single physician. “It’s a team sport, and I’m a team player. You rely on multiple specialties – medical oncology, radiology, pathology. The team is as big as a soccer team.”
“Oncology is interesting if you think about it,” he said. “What we can grow is closely controlled.
Sadly, you’re not going to grow another hand. Your body has systems to control what can grow and what cannot grow. And that’s pretty well-regulated. But you can grow a tumor that has an independent mechanism of control. The biology of the tumor is very interesting.”
But it’s not just the medical aspects of cancer that attracted him to the field. He’s just as dedicated – or even more – to helping people meet the challenges they face when dealing with a disease that potentially could be lethal.
“Even if your treatment is successful, having cancer will affect you emotionally and socially in ways you don’t anticipate. It’s very challenging for individuals and for families. Every individual faces these challenges in a different way. Some accept this as a fate and they’re not concerned. Some, despite facing a challenging diagnosis, seem to accept the cancer treatment journey with resignation.”
Dr. Paz said physicians have to consider that every person in front of them has a background that shapes them as an individual. They need to take into account where the patient came from, their family structure, their belief structure, their language, their education. Physicians have to communicate to every individual in a different way.
“I’m Jewish, and we have these four questions of Passover,” he said. “There’s a story of the four sons.
They’re each different. One is the son who knows everything, is interested in everything, and wants to know the story behind Passover. Then there’s the son who is educated but in denial, doesn’t want to be bothered with it. Then there’s the son who has heard of this but doesn’t even know where to start. Finally, there’s the son who hasn’t heard of it. To every son you answer their questions in a different way.”
He said those sons represent the people he sees as patients. There are those who know everything, and you can have in-depth conversation. There are those who deny all, those who know very little, and those who don’t know what’s going on.
“I have to answer in a different way,” he said. “As a physician this is one of the most interesting parts of medicine. I can see four breast cancer patients in a row, and they can have identical diagnoses. And not a single conversation will be exactly the same. Every one of the them will be different. Ultimately, the objective is to help patients and their families arrive to a level of comprehension of the disease and its treatment that allows them to make decisions. I find that amazing. There is never a routine.”
Dr. Paz said his own success in life is thanks to his family. He’s been married to his wife Sylvia for 40 years. “Without her I would have never succeeded.” They have two daughters and two granddaughters.
“Treating Hispanic patients for me is great, I love it, because I understand them extremely well. I have the same set of beliefs, the same background. When I speak their language coming from the same background, that creates a bond.”
He has a message for the Hispanic community.
“My No. 1 message to the Hispanic community in terms of health and wellness, the biggest challenge we face as a group, is obesity. Please take a look at your high school pictures and compare them to the high school pictures of your children. You’ll see the difference in size. It has to do with diet. It leads to health challenges with diabetes and obesity.”
His advice for a healthier diet:
Do eat grains, fruits, vegetables and some meats.
He said Hispanic populations have lower cancer rates than others, but bigger problems with obesity, which can lead to diabetes.
His words for cancer patients could apply to those with other diseases like diabetes as well.
“I often tell patients that cancer treatment is a marathon that unfortunately they must run. It’s a truly challenging experience. You will trip, you will fall, and your family and your physicians will get you up and will get you to the finish line. The biggest compliment I can hear from a patient and family is that they trust that I will be by their side.”
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